Hello, and welcome to the AAMFT podcast, your all-access pass to the latest news, developments, and thought leaders in the world of systemic therapy. We strive to relate, educate, and innovate, one episode at a time. I'm your host, Dr. Eli Karam, and we're brought to you by the American Association for Marriage and Child Care. family therapy. Our podcast explores topics that relationship-based therapists care about.
In addition to featuring unique conversations and interviews with established experts, our show provides information and education on direct practice and emerging trends in the MFT profession. For more information, please visit us at aamft.org. Thanks for listening and enjoy the show. Have you ever struggled reaching those difficult family systems, especially one where there's a teenager acting out?
Maybe they're into drugs or defiant behavior. You just can't get the parents to engage. Well, today on the podcast, we're looking at...
at one of our most empirically supported models in MFT, Brief Strategic Family Therapy, with its founder and developer, scientist practitioner, Jose Siposnick. Maybe you've never heard of BSFT, even though it has a nearly... 40-year track record of both efficacy and effectiveness.
But you've certainly heard of the precursors that influenced Jose and his colleagues to develop this model, and that is the great work of Salmanouchian in structural family therapy and Jay Haley in strategic family therapy. This is a great episode today, not only because Jose is a really engaging and thoughtful speaker, but because there's some really good stories and practical skills of how to work with people. to work and engage difficult family systems.
I know you're going to enjoy it, hopefully as much as I did interviewing Jose. We'll give you some background on our guest, Jose Sopoznik of the University of Miami Miller School of Medicine. He spent his whole career there.
He's received over $100 million in NIH funding and is among the best NIH funded investigators in the world with over 250 scholarly publications. He's a PI and the director of the University of Miami. director of the Miami Clinical Translational Science Institute. He's chair of the Department of Public Health and Sciences and director of the Center for Family Studies. He's pioneered the national effort to prevent and treat adolescent drug abuse and related behavior problems in Hispanic youth, which we'll be talking about today, and testing this family-based evidence approach.
known as BSFT, Brief Strategic Family Therapy. He has a profound interest in the role of context in development, behavior, and health outcomes, and he's dedicated his career to studying culture, family, neighborhood, all of those extra systemic factors that build environments as important context influencing minority populations. We'll be back after the interview. Dr. Eli Kerr, I'm back with you on the AAMFT podcast.
I am so fortunate to be joined today by a true scientist practitioner, a gentleman I've been looking forward to talking to a long time, and that is Dr. Jose Saboznik of Brief Strategic Family Therapy. Welcome to the show, Jose. The first question is always, we like to know the story behind the model developer, the scientist practitioner. How did you get interested in working? with difficult youth and their families.
It's such a pleasure to be here, and I truly appreciate your invitation. So, you know, the development of some of my early career were a series of sort of opportunities that I stumbled on. Back in 1973, I needed a job, and I needed to... I had to move back into my house, my family house, and I needed a job.
And so I got hired at the University of Miami in a project that had the mandate of unraveling the kinds of challenges facing immigrant Hispanic youth and their families in South Florida back at that time, 1973-74. What we found as we met with the families were their parents and their teens were in tremendous conflict and that conflict very much had a cultural flavor. That is, the youth had embraced the values of the American peers of autonomy and independence, and the parents were very much hanging on to the values of their culture of being hierarchical and expecting respect.
obedience for their kids. So these families were in tremendous amount of conflict. At the same time the person who hired me, who became the really the only true mentor that I've ever had for those first four years that were so formative in my life, she viewed the world through the lens of families and she was somebody who thought outside the box and encouraged me to do research on how best to help these families.
Even though at the time I did not want to do research. I wanted to be a full-time clinician, but I found research boring. But what happened was that when I saw the opportunity of doing research on solving the real-life problems of the families that we were seeing in the clinic, that was very exciting. This is the first time I ever got excited about research.
I think the best research is informed by our clinical experience. I've never wanted to study anything that hasn't. directly impacted me in the therapy room.
I always tell listeners on the show, I consider myself, it might not be popular in academic circles, but I consider myself a practitioner scientist, in reverse of the scientist practitioner. So you wanted to be a full-time clinician, and this female mentor turned you on to systemic thinking. Sometimes people say, well, I've always thought that way, but now I have the language. What was her, let's give her some credit.
What was her name and what did you learn from her? Her name was Mercedes Coppetta. She explained to me, He exposed me to many of the leaders of family therapy, the family therapy field at the time, from Salvador Miguchin, who was more methodical in his work, to Virginia Satir, who was a true artist and worked from the gut.
She was very much a systemic person. She was a remarkable woman. In my training program as a clinical psychologist, we never really mixed back then, in the 70s.
Research and clinical work, they were totally separate. So Mercedes Coppetta allowed me the opportunity to see the families, to see what was going on with them, and to try to create a research program that really emerged from what I was seeing in front of my eye. And that was an amazing experience.
She was a very systemic therapist, but she didn't quite know Beyond that, she had just graduated herself, even though she was older. She had been a mother, she had a bachelor's, then she was a mother for a number of years. Then at 40, she went back to school, and at 50, she got her PhD.
And two years after that, she called me to join her team. And together, she and Olga Hervis, who's my collaborator in the book, And myself, we learned about all the family therapy models in the field and began to search what would fit better our population. And let's talk about that population.
Latino started out in Miami where you spent a 45-year career working with that population. And sometimes a stereotype of Latino populations is they are very close-knit family values but not really open to outside intervention from a... therapist or a mental health professional.
Talk about what that was like starting to do that work as a young man and gaining access to working with people that are kind of skeptical of family therapy and mental health. So actually, it's a great question. So our population was mostly Cuban immigrants and Puerto Rican families that have been here for half a generation to a generation.
The Cubans were much more recent immigrants. from just coming to maybe a maximum 10 years, having been in the U.S. We found very early on that we needed to learn what the language of the family was and to use the language of the family. For example, there is absolutely no reason to call what we do therapy to the family. Therapy is our jargon.
For the family, it's a meeting. So, you know, we have to... I think, and this is something that Mercedes Coppeta was very good at, in how to present what we do in a way that was consistent with the way the Hispanic culture thinks and stay away from the kind of terms that were scary or foreign to Hispanic families. So we met with families to help them. We didn't have to call it therapy.
We didn't even have to call them sessions. So we were able to very early on. get around some of those cultural barriers by not confronting them, by not using our language, but the families. Yeah, you joined with them and you didn't use jargon. And before we get into what is brief strategic family therapy, I am curious your own family of origin and what you learned from them, both good and bad, and how that also suited you to work and research a population like this.
Well, sometimes I find it hard to think about what I learned from my family that helped me in my developmental trajectory. I grew up, you know, Cubans have a... reputation of all having been rich. Well, I grew up in a very poor neighborhood in Cuba and the suburbs of Havana. When I was growing up, we never lacked food, but my father was always in debt and very stressed.
He was a person with very little frustration tolerance, which meant that when he got frustrated, he would explode and he would take it out on whoever was closest by. He was a wonderful, loving man sometimes and a very scary man some other times. And he would beat up my sister often, but I was less likely to be beaten up because I had asthma as a child.
And when he started to beat me up, I would have an asthma episode, so my mother would protect me. So my mother was my ally against my father, if you will. A typical, as we would say, Oedipal complex. In my family, I don't remember rules.
Everything was by the seat of the pants. We didn't have a lot of traditions. We did sit to lunch together, some of us, but we never made the point of sitting together for meals, the whole family.
That usually didn't happen. So it was a sort of chaotic family. And we clearly, my sister and I didn't have a happy childhood. In fact, I didn't know there was such a thing as happy childhood in many years, that there were children that could have happy...
childhood until many many years later. You know I heard of parents that wanted to have, of kids who wanted to have parents that were perfect, that didn't they know that they were just the way they wanted it. I never wanted that.
I just wanted to be out of there. And what I see now is how doable it is to help families and how, I hate to use a term, but almost when you know what to do how easy it is to turn anger, negative interactions into positive ones. And I really wish family therapy had been available when I was a child.
It would have made a big difference in many years of my life. That's an amazing story. And we'll talk about a second, you know, many times in your model and in the field in general, the IP, the identified patient is the acting out youth.
But in every system, I always say I've never seen any system where one person is 100% of the blame. So you Yes. How different would your life have been had you gotten some family therapy? And how would a brief strategic family therapist interacted with your dad, who in a lot of ways we would view as someone who's kind of treatment resistant?
And maybe we can talk about how brief strategic family therapy works with difficult to engage parents, not only difficult to engage children, but let's talk. I mean, that's an amazing story. So you come over from Cuba, you come to Miami, you get mentored by Mercedes.
And then how do you get the idea? to take these strategic and structural principles and put it into a nice, tight, manualized package and start to develop your program of research and dissemination known as pre-strategic family therapy. Timeline-wise, to orient our listeners, when does that come to fruition?
Well, from the very beginning, I mean, we knew so little about what was going to help these families, except that we could see very clearly that these were family. conflicts. This was what was pervasive in all of these families that brought their kids or complained about their kids and couldn't bring them into therapy.
And so we really began to work with them. We began to listen to some of the giants in the field and bring them in and have them train us. We started to say, what fits? What fits between what is being discussed out there and our population? And very early on, the work of Minuchin, who, as you know, was developing Philadelphia for poor Hispanic families and African-American families, seemed like a good fit for a number of reasons.
These were families who wanted a therapist who was in charge. They didn't like the kind of therapist who left it up to them to solve the problem. They wanted somebody who took charge of the session. They wanted to feel that the... therapist was the expert but we could be the expert in process not in content we didn't have to tell them what to do but we can guide them to do it in a different way So they definitely wanted somebody who was an expert.
They wanted somebody who was oriented to the present and not to the future. They wanted to solve their problem now. They were in an emergency situation, in a crisis. They didn't want a therapy that looked for long-term growth. And so the notion of strategic was very effective because we were able to focus on the presenting problem.
But of course, we extend the strategic beyond that to focus on the interactional patterns that were linked to the present problem. And these were families who very much wanted a therapist that was direct, that was involved. They didn't want these seat-back therapists as you had in many individual therapies at the time. They wanted therapists who got in there and in the session with them. and helping them to solve their problems.
So we found a fit between structural, from Salvador Minuchin, and strategic with the person that we worked with was Jay Haley. And we also had a good fit, found a good fit, in many of the techniques from structural family therapy that Minuchin and his colleagues talked about, joining, tracking, reframing. restructuring, these were all things that we found that we could do with our families. And as we tried it, that it helped. It's interesting when I think of the name of the model, because some listeners are familiar with it.
Others will be being exposed to it really for the first time after listening to this. But I always thought the choice of calling it brief strategic was interesting, because it has, I think, many structural elements in there. So it's almost like it's a brief...
structural strategic family therapy. How did you ultimately decide on the name? And then I'm curious, we've had Chloe Madonis on the show before and many people that worked with the late great Jay Haley.
I'm wondering your impressions and time with Jay Haley, what that was like. If I were naming the approach today, I would name it restructural strategic family therapy. But I don't think we could see the distinction so finely back in the 70s.
Maybe it was part of our clumsiness that we didn't put all the terms in there at the time. Jay Haley was a wonderful, loving, caring, warm, sweet man. And Haley and Minucci were very different.
We like to see Minucci work because when he worked, he was able to really demonstrate what he was trying to say. We love to hear Jay talk. talk because he was such a humanist in my view and we love the language that he used in describing the families and the work and those guys were very close friends and they you're right sal like to be in there with the family the more the merrier and jay like to be behind the mirror conducting a very strategic way yeah i love classic structural and strategic techniques some are timeless you Some maybe haven't aged as well.
I'm wondering what you think of the now somewhat taboo, paradoxical, and indirect interventions that Jay Haley certainly learned from his mentor, Milton Erickson, and that places like the Mental Research Institute in the 70s pioneered. So what's your take on paradoxical interventions, Jose? I never liked them. And our whole team never liked them.
And particularly in the early days, we were always working with young therapists. You know, there wasn't a cadre of therapists who had been trained in family therapy in Miami at the time. In fact, I think there was hardly anybody in Miami who had ever been trained in family therapy in the early 1970s. We thought that to do a paradoxical intervention, you really have to be very seasoned. You need to know what you're doing, and you have to know how to recover if it goes south.
And we felt that for young therapists, it was not the right tool. Even today, we do a lot of training of relative young therapists. therapists who've studied, completed their family therapy training, but maybe in their first few years of their job. And we think that paradoxical interventions is just not good for people who are not very seasoned.
But beyond that, personally, none of us ever liked them. We just felt that it was very paternalistic. So we never did them.
Mercedes Coppetta never did them. Olga Hurwitz never did them. I never did that.
Also, when you're trying to join and build trust with family and establish credibility, working in a non-direct, strategic, paradoxical way is, I think, antithetical to try to build an alliance and build that trust. However, Jay loved those. So I wonder, yeah, of the fit between that.
But as you said, the real similarities, if I'm a student of family therapy, and maybe I have never seen a brief strategic family therapy session or manual, and we're going to talk about this great new resource as we go along. But if I've never seen any of that, there are... The commonalities as far as linking to the presenting problem, working in a brief way, studying these patterns of interaction.
Talk now about the model. If you had to distill down in a couple minutes the core of brief strategic family therapy for someone that's never really experienced it, what would you tell me it is all about? Well, there are two...
Two. Important message that I would want to leave the listeners with about what BSFT is about. BSFT is above else a love therapy. I believe that families change because the love that's trapped behind the anger is allowed to flourish. And our job as BSFT therapists is to transform family interactions from anger to love.
from negative to positive, from conflictive to collaborative, and from habitual and repetitive to proactive and appropriate to the moment. And I think this is all very doable in BSFT to transform these interactions. But I think this is not something we knew at the beginning when we started, but as we mature, and it was part of our own maturation as... human beings that we recognize that reframing was just not a technique that the transformation of interactions took place when we were able to transform negative interactions into the human bond to hot to heighten the presence of the human bond that exists among family members bsft as i view it now is very much a strength based approach that transforms problematic interactions into constructive interactions using the family strengths, the underlying bond that causes families to be in conflict.
People fight because they care. You know, family fights where the fighting is a marker of their connection. The more bitter the fight, the stronger the connection.
So we focus on that bond, on the fact that family members fight because they care. And you'll hear me say a lot of times to A parent, well you don't fight with a kid ten houses down the road because you don't care for her. You fight with your daughter because you care deeply for her.
For her making the best decisions now that will become the foundation for a bright future. You deeply care for this child. Explain to her why you care, how are the many ways you care, and what is it that you want for her, for her better future.
I think now this is a real crux. I think that the... therapy cannot be successful without our being able to cause this transformation to the strengths of the families, to leave the family focused on its strengths. And the other very important message about BSFT, which I've already said or alluded to, is BSFT is focused on repetitive patterns of interactions that are linked to the presenting problem. So that's a strategic aspect.
A lot of strategic therapies classically were focused on the presenting problem. We are focused on the presenting problems and the repetitive patterns of interactions that are linked to those problems. That's what we diagnose. And in a very focused way, that's what we target for change in BSFT, which is one of the things that makes BSFT brief. I don't know if I have...
time, I'd love to talk about what makes BSFT brief. Do that right now. I'd love to hear it.
I'd love to hear that. And I'd also like to hear about how you engage, especially acting out youth that many times have co-occurring drug problem or oppositional defiant parts that don't really want to sit down for a family meeting, whether we call it therapy or a meeting, they don't want any part of it. So yeah, talk about what makes it brief.
And if I only have a short amount of time to work with someone that's hard to engage, how am I going to do that? Well, the first step that we take after engagement, actually part of engagement as well, the therapist establishes what I think of as a highly participatory therapeutic system and creates a new system which includes the family and the therapist. in which the therapist is the leader and works with the family as somewhat of an insider but not as a family therapist as the leader of that system.
This therapist establishes what I like to call a governing coalition in which she offers each family member something that that family member wants in order to be in family therapy and so Like in politics, by giving everyone something they will want, the family members elect the therapist as the leader of the therapeutic system. This increases the family member's willingness to follow the therapist's leads. It brings down dramatically what people call resistance, which is the term I don't like to use, and I'll talk about that a little more later.
Give us an example, Jose, of how... Let's use a typical example that all of our listeners can relate to. I have a teenager that doesn't want to be there.
They want to be with their friends or their peer group. How do I get the buy-in from someone like that? If I am the leader, how do I get... the credibility to even be elected a leader from the disgruntled defiant teenager well first of all let me say you'd be surprised that it's not just a teenager that there are many family members who for different reasons may hesitate being there or having other family members there so the mother only wants to be there maybe if she can have her agenda Which is to get the kid off drugs. The father may only want to be there if, you know, his wife stops nagging him and lets him be part of the parenting subsystem, of having a say in how to raise this kid.
Now, the father may say, you know, she's always babying him and, you know, I think he needs a little more... you know we need to be a little stronger with him and there's just no way with her and you as a therapist may say to the father you know there may be something there and it may be that if the two of you work together and you know we have together her caring for the child and your strength in managing the child that together you really can do something so i think it'd be very important to have you in therapy and then you talk with the child and you want to know what their frame is. What is the frame of each family member? And the child is going to say, they're always bugging me. You know, they don't let me breathe.
I don't know when they're going to explode. I don't know when they're going to let me go out or not go out. It's a mess. And they're always fighting. And you say to the youth, you know, I can help you with that.
I hear you. You don't want your parents to be bugging you all the time. And I want to work with you. If you come into therapy or you come in to meet with us, I'm going to help you with that so your parents are not always bugging you. I hear you, that they're always fighting and that annoys you.
Listen, we can work on that. And so on. So you establish a governing coalition. You have to find out what each person wants, what their frame is, and you have to offer them.
realistically something that you could provide them and in fact these things I've said are all things we could provide them in fact in if they come into BSFT. You don't like the word resistance what word do you use? Okay so I want to talk about that a little later.
Let me give you my definition of resistance. I struggled with this for years because of course therapists want to attribute resistance to the family or to a family member and so I wanted a way to get away from that because in systemic thinking resistance really is at the systemic level it's never one person or one subsystem it's what they all do together so I came to redefine resistance as the behavior of the therapist that causes the family to object to it and not change. Resistance, I only use it when the therapist is unwilling to change and behave in a way that will elicit the family's love and more constructive relationships in the family.
So I never attribute it to families. Families can be reluctant to come in and we can work with that. I think... That is the real goal, is to find the driving force for each...
in that system. And if you can be helpful to them and you can create a credible conduit, they will buy in. And I think you have a brief window to do that, pardon the pun, in your model.
So you have to be, to know what their driving force is very quickly. One of the questions I always get in working with a kind of a high risk family system like this is Some people in the field will say, well, you can't work with someone if they're addicted to a substance or on drugs. They have to be clean before we can work with them. Well, in the front lines of doing this work, I don't think that's necessarily realistic with many teenagers. So especially the types of populations that brief strategic family therapy has been so effective with.
How do you work with someone that is using a lot of drugs in order to really have the best shot? at a good outcome, both individual level and family level? Well, I think I happen to do a lot of work in addiction.
Separate from BSFT, I direct an NIH-funded center on addiction treatment. So I have a lot of experience with real addiction. And so we have to say, what does addiction mean or what are we talking about?
It's for adolescents. Addiction is so what we call... Substance use disorder according to DSM-5 is extremely rare. So these, and in fact, even for those who have substance use disorders, which it does happen, there are some of those who need medication treatment. Like if you have someone with moderate to severe opiate substance use disorder, you need to have a treatment with an antagonist or an agonist like buprenorphine or naloxone.
But most of these kids, 98 or 99% of these kids, have drug use that still can be worked with. And we're working with our family. Let me say, substance use is content. Content that sometimes can be dangerous, as any case when there is a danger to harm for self.
and others you may have to attend to content. But outside of that, we're attending to process only. And so what are we attending to? We're attending to the conflict at home.
They're fighting because the kid is out until 6 in the morning using drugs and stealing. Well, what do we have to go to? We have to go to, Mom, I see how worried you are.
I see your pain. I see the love that you have for this child and how you want the best for him. Tell him that.
We are family therapist process experts. So this gets to one of the balancing acts in the field. So I'm asking you the tough question. So here's another one.
So to what you said is true in the sense that the acting out, the defiant behavior, in this case, the drug use is more of a symptom than the actual problem. And you're looking for the, as you said, the love under the anger, you're tapping into the process. However, to get funded, you have to tie into these big problems. And you have a 40-year career of funding and it's really without those diagnoses, it would be impossible for your program of research to be where it is.
So what we're talking about now is walking that line between seeing strength and health, but also understanding how it ties into these larger macro issues and diagnoses. How have you done that? And how have you kind of walked that line to be both?
speak the language that allows you to study the work, but also see strength and health, if you know what I mean. And that is really the challenge of being a systemically oriented therapist that has to work in a world of linear thinking and psychopathology to see strength and health even in the most dysfunctional systems. The funding agency is interested in drug use, in delinquency, in the kinds of symptoms that are troublesome to society, in parents who neglect and abuse, because we also have funders that are, that's what their ultimate goal is, to prevent reoccurrence of abuse or neglect.
But we do that because our strategic goal is to eliminate the presenting problem or reduce it to where it's no longer a problem and to do so by changing the patterns of interactions that are linked to that symptom. So actually funders are very interested in what's called research mediators, the mechanisms by which the... Intervention has its impact and they will fund us to study that specific interventions that we do in BSFT bring about specific changes in family interactions that in turn result in reductions in drug use, in delinquency, or in parental abuse or neglect. That's all fundable. You just have to link it together.
Yeah, and you have done an amazing job at that. But the reason you're on the podcast, I mean, there will be some researchers and academics listening to this, but these are frontline clinicians that listen to this. And I think since that a lot of empirically supported treatments, they're great. And we have many in MFT that target these same type of populations. But it's usually very proprietary.
Unless I work in an agency or have been trained in this way or part of a research group, I'm not getting exposed to this. So. You and your longtime colleague, Olga Hervis, have just released Brief Strategic Family Therapy, and it is a living, manual, accessibly written.
I've used it. I've let beginning students and more experienced clinicians use it. Tell us about the dissemination of your model broadly, and then what can people expect when they read the new book?
Well, I think when people read the new book, one of the things they'll get tired of hearing Which I hope they do get tired of hearing because it's our intention is that we're process oriented. That the focus is on interactional patterns throughout. Keep the focus on interactional patterns.
Content is the realm of the family. We change the way families interact so they can solve their content problems. We never help them solve their content problems. We give them the tools for them to solve their content.
problems. This is very important for many reasons, not only because this is a mechanism that brings about relief in the symptoms, but also because families come to us with a lot of content problems. They have a lot of complaints. And if you focus on the complaints, you get you as a therapist become just as overwhelmed as the family. But the family only comes with a handful of interactional patterns that need to be changed.
And so That's more doable in a brief therapy. It's more doable than any therapy, but particularly in a brief therapy. The other aspect that is really critical is that BSFT is diagnostically driven. We, and this is not just research, I mean, we've done a lot of research on this, but this is the clinical model.
When the family comes in, the whole family finally comes in for the first session after we've done the engagement, we... Don't ask the family to tell us what is wrong. Rather, they will start to tell the therapist what's wrong, and mom will say, Loretta is out until all hours, she's throwing fits all the time, blah, blah, blah, blah. And I will say as a therapist, Mom, would you mind telling Loretta that? And mom, of course, it will take a little work.
Mom would say, I've told her a million times. I know you have, but I want you to tell her here where I can see it and I can help with it. And then mom tells Loretta, and we see what mom does with Loretta and how the interactions in the family develop, who triangulates themselves.
What happens when mom tells her? Maybe Loretta attacks mom back. and what we see is that they're diffusing.
And so it's a family that diffuses and we have to help them with diffusion. So we have to help them to stay on the topic until they solve it. So we very quickly, in the first 10 minutes of the session, of the first session, we are diagnosing. Our work is primarily family members interacting with each other. The interaction is in the present.
What they talk about can be in the future or the past, what you did or what's going to happen to you in the future. But the interactions are on the present. So the therapist needs to be very able, and this is an ability that a therapist has to develop, to focus on what is happening in front of them in terms of the interactions.
And they're happening now. And then the therapist has to learn to transform. those interactions as they are occurring.
So once you have gone to 15 or 20 minutes of seeing the interactions and you're know enough that you begin to know what you need to change, you begin to intervene. Yes, mom, I hear you. I hear you that you're very concerned about this, but I want you to stay on the one topic.
I want you to choose what of all those things is what you really want to choose first. Well, I want to actually, I'll give you an example that I had this week. This is an African-American single mom family with a 15-year-old boy.
who looks like a 20 year old and very smart and very very capable and he gives mom a whole litany of complaints and so the therapist says okay i want you to choose one that you want to talk about and so i don't want her to be reading my phone every day and see what's going on in my life and so then we get them from diffusion to stay on one topic And to carry that topic through. The content is not important, but as they carry that content through, we can work on how they interact. On mom listening, or reframing as you want your mom to trust you, and what would that look like? Mom, what would it look like if you trusted him? What happens that you feel the need to look into his phone?
And so we're able to have... a conversation about a topic. It doesn't matter what the topic is, that's content. But around that topic, we're able to work on transforming interactional patterns into patterns of interactions that are positive and that can be, they can hear each other and then there can be some negotiated solution. Yeah, that's a great example.
Okay, I have a... A couple more questions. And like I said, I'm going to ask you a tough question. We said that the IP, usually the teenager, is just part of the system, rather. And it's actually, the parents can be just as problematic in many ways.
So let's imagine you had your father or someone like your father, very tough, patriarchal, masculine, not wanting to really talk or do therapy. How would somebody... Reach out to someone like your dad from your family of origin.
We'll go full circle in our interview from where we started when you were a kid to where you are now. How do you work with someone like your dad was? Well, you have to join in a way that is acceptable to that individual.
So, I hear you. You're the boss in this family. But the truth is, my family had no boss. He was not able to get it together to say what needed to be done by anybody. But in the case of somebody like my father, you would have to first join in by saying what he would like to hear, which is we know that you want to be the boss in this family and you have every right to be.
So let's let's talk about what you would like to see. Let's hear you. So we need to hear from him what his frame is from his wishful thinking perspective.
And then we need to explore initially how we can offer some of that. While at the same time, families to function well have to have balanced power sharing. And how do we do that in a way that is more acceptable? So, for example, when you have a powerful member of the family, often you have to get the powerful member of the family's permission to let the other person speak.
And you have to have the powerful member of the family in charge of creating and negotiating. negotiation with a less powerful member. So you're tracking that power as a way to bring the relationship into a place where there is negotiation.
And once there's negotiation, you begin to have a more balanced relationship between the two. So you see what I'm doing. I'm using his power position.
I'm letting him be in power. I put him in charge of the negotiation process. But once he enters into the negotiation process, you begin to have a more balanced power distribution between mom and dad. What I love about our hour here today, sometimes people that are frontline clinicians believe empirically supported models are something that only exists in this pristine ivory tower in these highly controlled situations.
This is a model that is both efficacious, but also very effective, and it will work in real life situations. And you're... Your great, vivid stories have proven that.
Jose, I want you to have the last word. Anything else you want our listeners to know? And then what?
You've had such a great run the last 40 years with Brief Strategic Family Therapy. What is, if anything, next? for you and your program as far as left to accomplish? Well, I want to go back to this family that I supervised this week because I was very struck about something that is very present today. This was an African-American family, and the conflict was primarily about a mother who's afraid for her son, who's...
Going out in New York City, where, as she said, you heard what happened earlier this week, that a white woman called the police saying that she was being attacked by a black man. The black man taped her on her phone, and so he was able to show that the woman was not being attacked, and it was a false report. But you see what's happening here, and you know what happened that... the other day you were very loud and white neighbors called the police on us.
This child is super mature and articulate. And he says, well, I know what to do. I'm not going to resist the police. I'm going to cooperate. And here is this 15-year-old who looks like a 20 or 22-year-old, a big guy, who's asking for autonomy.
And he's being very clear. I want you to let me do. You know, one day I'm going to.
go away and I have to be learned to do, but for myself and I have to do it now. And he's asking for autonomy, but he's only 15 years old and he doesn't have the experience to understand that what happens with a white policeman may not be rational. He's being rational, this boy, but what happens is not going to be rational and he's not going to be able to control that person's behavior.
And a mother... who is trying not to impose on this kid and stifle him, but yet she knows that to protect him from what's going on in the street. The content is new, but the process is what we've been working with for many years. This tension between a parent being nurturing and providing guidance and the teenager accepting some of that guidance.
and a teenager who wants to be, to separate, to grow onto their own. And this is the crux of what we do in therapy every day. We have to help parents and their youth work this fine line where parents have the experience to keep this kid out of trouble, but they have to develop these skills to do so in a way that doesn't feel stifling to the youth.
So... I think of BSFT very much as a skills building interaction. We build the skills to interact in a more constructive way that lead to successful outcome. And so that said something very important about the role of the therapist. The skill of a family member talking to me as a therapist is not very useful.
So whenever a family member is talking to the therapist, I'm telling the therapist they're not learning anything they're going to be able to use when they leave here. Your job is to keep the interactions focused among family members and they are developing new skills that will be useful to them once they leave therapy. This is a skills building interaction. We're building mastery in adaptive interactions that lead to the kinds of outcomes the family wants. Wonderful, wonderful.
It has been so great to have you this hour. We have never met, but you are very accessible. And if people want to learn more, Jose, or even correspond with you, where should they go?
How can they reach you? Well, I'm at the University of Miami. My email is J, as in my first name, Jose, and as in the first letters of my last name, S, Z as in zebra, A, P. C-S-E-N-C-H-A-R-L-E-Z-E-N-Z-E-B-R-A at Miami.edu. I would say that the first thing people would want to do if they want to learn more is to look at the new Brief Strategic Family Therapy book that was published this year by the American Psychological Society. Association and they can go to the Americanpsychologicalassociation.org website to get the book or Amazon.
But the Psychological Association also has a training tape of me doing BSFT. So you can get both the book and the training. from the American Psychological Association and that would be a next step in learning about the model.
The book is written in a very accessible way so it is not jargony, it is you are a process expert as family therapists, we are process experts and the book very much speaks to that and also talks about the pitfalls of What not to do. Today, we talked about a lot of what to do. The book also does a nice job of talking about how family therapists, when they're working with these systems, also some common mistakes that they make. Right.
Okay. Thank you so much. It was wonderful to have you on the AMFT podcast, Jose.
Thank you so much for being here. Eli, I'm honored that you included me in this extraordinary series that you lead. Eli, back with you. Wrapping up another installment of the AAMFT podcast. I really enjoyed talking to Jose.
Sometimes I know our guests and I have met them throughout the years. I'd never met Jose, but I had been a fan of his work and program of research for a long time. But I had no clue how passionate he was about the clinical application of what he does. And you can tell he is a clinician as well as a scientist, a great scientist practitioner model.
Now, actually, we talk about user feedback. Jose had listened to the show and had seen an article about the podcast in AAMFT Family Therapy Magazine and had contacted me, and he was on my list anyway. So this is always great when a plan comes together that way, and we love hearing from you. That drives our content on the show. Easiest way to get a hold of me. is info at eli carom.com that's e-l-i-k-a-r-a-m.com and the twitter handle is at dr eli live you can follow the conversation amft is at the amft and jose if you want to talk to him he gave you his email but you can find out everything you want to know about bsft that's beef strategic family therapy at bsft.org And there's a manual as well from NIDA that you can check out and download for free.
Until next time, my friends, stay safe. Most importantly, stay systemic.